Discussion: Policy and State Boards of Nursing NURS 8100

Discussion: Policy and State Boards of Nursing NURS 8100

Policy and State Boards of Nursing NURS 8100 Discussion

Within the far-reaching and multi-layered realm of policy and reform, government at the
state level plays an essential role. Consider the federally enacted PPACA’s individual
mandate which sought to increase the number of consumers who receive insurance
coverage and, therefore, greater access to care. In a system that is already stretched
beyond capacity and confronting a nursing shortage, how can the health care system
meet this increased demand? Since state boards of nursing determine scope of
practice, it is important to stay up to date and current with the policies and regulations
that are created by the state board of nursing.
To prepare:
 Review the Thomas, Benbow, and Ayars article and the Watson and Hillman article
focusing on how states regulate advanced nursing practice and how legislative changes
are impacting scope of practice.
 Visit your state board of nursing website and/or contact the board to determine how the
state board controls advanced practice through regulations.
 Determine if your state board has created any new policies or regulations that address
changes to scope of practice in response to legislative changes.
By Day 3
Post a cohesive response that addresses the following:
 What are the most recent regulations promulgated through your state board of nursing
for advanced practice?
 How are the state regulations supported within your place of employment?
 How do the states differ in terms of scope of practice? What impact does this have on
professional nurses across the United States?
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues selecting someone from a different state
and comparing your state’s scope of practice with your colleague’s. Share any insights
and implications for practice.
Note: Please see the Syllabus and Discussion Rubric for formal Discussion question
posting and response evaluation criteria.
Return to this Discussion in a few days to read the responses to your initial posting.
Note what you learned and/or any insights you gained as a result of the comments
made by your colleagues.
Be sure to support your work with specific citations from this week’s Learning
Resources and any additional sources.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 9 Discussion Rubric
Post by Day 3 and Respond by Day 6

To participate in this Discussion:
Week 9 Discussion

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Learning Resources

Note: To access this week’s required library resources, please click on the link to the
Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Chen, A. S., & Weir, M. (2009). The long shadow of the past: Risk pooling and the
political development of health care reform in the States. Journal of Health Politics,
Policy & Law, 34(5), 679–716.
Note: You will access this article from the Walden Library databases.

The authors provide an analysis of varying state health care policies, with a basic
premise that health care risk is either “pooled”—shared, or “actuarial”—segmented by
risk level. Most states have taken a segmented approach to health care, and therefore,
have not solved health care issues such as rising costs and access to care. The authors
maintain that federal action is needed to create a uniformed approach to health care.
Junghee, L. (2009). Cultural, social, and political influences on state-level indigent
health care policy formation. Journal of Policy Practice, 8(2), 129–146.
Note: You will access this article from the Walden Library databases.

This article provides details on a 50-state study of Medicaid spending. The authors
concluded that political and economic factors can positively predict individual state
Medicaid spending, and that actual need has a negative impact on spending. In
conclusion, a uniform, federal structure may be the only method to ensure equal access
to Medicaid.
Mills, A., Engelhard, C. L., & Tereskerz, P. M. (2010). Truth and
consequences—Insurance-premium rate regulation and the ACA. New England Journal
of Medicine 363(10), 899–901.
Note: You will access this article from the Walden Library databases.

O’Connor, J. C., MacNeil, A., Chriqui, J. F., Tynan, M., Bates, H., & Eidson, S. K.
(2008). Preemption of local smoke-free air ordinances: The implications of judicial
opinions for meeting national health objectives. Journal of Law, Medicine & Ethics,
36(2), 403– 412.
Note: You will access this article from the Walden Library databases.
Sommers, B. (2010). Enrolling eligible children in Medicaid and CHIP: A research
update. Health Affairs, 29(7), 1350.
Note: You will access this article from the Walden Library databases.

The enrollment and retention of eligible children in Medicaid and Children's Health
Insurance Program (CHIP) is a health care concern. The article concludes that some
state processes have mitigated this issue but other requirements, such as providing
citizenship documentation, may have a detrimental effect. Therefore, these concerns
should be incorporated into the implementation on PPACA of 2010.
Thomas, M. B., Benbow, D. A., & Ayars, V. D. (2010). Continued competency and
board regulation: One state expands options. Journal of Continuing Education in
Nursing, 41(11), 524-528.
Note: You will access this article from the Walden Library databases.

The authors use the changes instituted by the state of Texas in regard to the licensing
of nurses to illustrate the need to adapt state licensing requirements to the changing
diversity and scopes of practice among nurses.
Watson, E., & Hillman, H. (2010). Advanced practice registered nursing: Licensure,
education, scope of practice, and liability issues. Journal of Legal Nurse Consulting,
21(3), 25–29.
Note: You will access this article from the Walden Library databases.

The expanded role of the advanced practice nurse has led to changes in licensure,
education, certification, and scope of practice definitions. The author points out that this
expanded role has led to increased liability and accountability concerns as well.
Yue, L., Harrington, C., Spector, W. D., & Mukamel, D. B. (2010). State regulatory
enforcement and nursing home termination from the Medicare and Medicaid
programs. Health Services Research, 45(6p1), 1796-1814. doi:10.1111/j.1475-
6773.2010.01164.x
Note: You will access this article from the Walden Library databases.

Those nursing homes receiving Medicare and Medicaid funding are subject to strict
quality and safety regulations. This article examines the consequences of enforcing
those federal quality standards.
Optional Resources
Wieck, K. L., Oehler, T., Green, A., & Jordan, C. (2004). Safe nurse staffing: A win-win
collaboration model for influencing health policy. Nursing Education Perspectives, 31(3),
160-166.

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